Breast Revision

She did not want to have a lift when she had her augmentation. So a big saline implant was used and she drooped even more. She was replaced with a smaller silicone implant and given an anchor scar lift.

Capsular Contracture

This woman had severe capsular contracture, which made her implants high, hard, painful, and round. The scar tissue was removed, and new teardrop gummy bear implants were placed behind the muscle.

Capsular Contracture (Right), Implant removed (Left)

This patient had multiple attacks of capsular contracture. The right implant became infected and was removed. Scar tissue was removed from both breasts, and new, larger implants were placed.

Capsular Contracture (Left), Lateral Malposition (R)

The right implant is low and outside. Strattice was used to strenghten the weak tissues in that area and move the impalnt inwards. The left had recurrent contractures, and Strattice was used to reduce the chance it would happen again.

Capsular Contracture, Drooping, Wants Larger Implants

The scar tissue made her implants high, hard, and round. Scar tissue was removed and Strattice used to reduce chances of contracture. Larger implants were placed. Her tissue is droopy, but she did not want a lift.

Drooping, Capsular Contracture

The contracture pulled the implants up, and the drooping allowed the tissue to slide off of them. Scar tissue was removed and an anchor lift was done.

Capsular Contracture, Severe Tissue Deformity

This patient has had multiple operations through the nipple for capsular contracture, resulting in a horrendous deformity. She was treated with removal of all the scar tissue and careful sculpting and repositioning of her breast tissue.

Deflating (Right), Superior Malposition (L)

Her right saline implant started getting smaller because of a leak. The left was always too high because the pocket was made too high. The pockets were equalized and new silicone implants placed.

Implant Removal

This patient loved her implants! But she had gained weight since she first put them in, and no longer wanted them. When tissue is good, the results of an explantation are excellent.

Drooping, Wants Smaller

She wanted smaller and perkier breasts. So the impalnts were removed and replaced with smaller implants, and an anchor scar lift was done. She is only 3 months after surgery, but with time the breasts settled and the scar faded.

Rippling

Her implants were supposed to have been behind the muscle, but the muscle was so damaged that there was none left to put the implant behind. Strattice was used to add coverage and keep what little muscle there was over the implants.

Capsular Contracture

A very typical before and after of a capsular contracture. The round appearance with the upper bulge and downpointing nipple is corrected by complete capsulectomy and placement of a new implant.

Lateral Malposition, Wants Smaller

Her implants have fallen down and out, leaving her upper inner breasts empty, her cleavage wide, and causing her breasts to rub against her arms. Even with smaller implants, by closing the outer pocket she achieves more upper fullness.

Capsular Contracture, Wants Larger

Scar tissue around her breast implants is hard, round, and unnatural looking. She wanted more cleavage, soft breasts, and prettier breasts. Removing the scar tissue and placing larger implants improved her cleavage and her shape.

Capsular Contracture, Nipple Distortion

She has had multiple occurrences of capsular contracture, so Strattice was used to prevent it from recurring. It was also used to fix the defect on her areola. This is a very disfiguring complication of that incision.

Note that in the preop the right nipple looks high and the left looks low. That is because a high implant pushes it down and a low implant tips it up. By equalizing the position, this is solved. She wanted to be natural without the R upper bulge.

Inferior Malposition (L), Rippling

The left implant is lower than the right and the pocket was closed off. Her implants are still too wide for her, which is why they are so close together. Rippling is visible on the sideways photo, and this was helped by changing from saline to silicone.

Rippling

Her saline implants had a lot of rippling that could be felt. They were also in front of the muscle. Since she is so thin, silicone implants were placed behind the muscle, reducing her rippling and improving her appearance.

Symmastia, Inferior Malposition (L), Wants Smaller

This patient did not know exactly what was wrong. She just knew that they were too big and misshapen. The right was far inward, and the left was inward and low. The pockets were equalized and implants were placed which fit her body.

Rippling, Wants Larger

Her implants were too small and too wide apart. Her breast skin was not filled. A slightly larger implant and removal of scar tissue gave her better cleavage, shape, and treated the rippling.

Wants Larger, Rippling

She is round and far apart, so it looks like a contracture. But it is actually a high profile saline implant (see rippling on side view.) Larger silicone implants were placed which improved her cleavage, shape, and rippling.

Superior Malposition (Left), Deflation Saline (L), Desires Larger

Her left breast was always too high and recently started leaking and getting smaller. She also wanted to be larger, so larger silicone implants were placed.

Lateral Malposition, Wants Bigger

The left implant was positioned too low and to the side. Moving that inwards would increase upper fill. But she also wanted the right to look more round but not too fake, so slightly larger implants were used.

Inferior Malposition, Wants Smaller

Her implants were positioned too down and in. They were also too big and fake for her very lean body. The implants were better centered under her nipples and smaller, less highly projecting implants were placed.

Rippling

Like most rippling patients, notice how thin she is. In reality some of her improvement may have been due to her gaining weight. Still, there is a significant improvement in the lower inner left breast from tightening the pocket and changing to silicone.

Symmastia

This poor woman developed symmastia because her implants were way too big and she has a concave breast bone. Her skin was so stretched for so many years that it did not snap back. If she wants to fix that she would get a lift.

Lateral Malposition (Left), Wants Smaller

The left implant was placed too low and to the side. She also just wanted her breasts to be less obvious. So the pocket was corrected and smaller implants placed.

Inferior Malposition, Capsular Contracture

Her implants were too low and were contracted. The scar tissue was removed, the implants raised, and new smaller implants were placed behind the muscle.

Replacement after Removal

She had large implants removed because she was getting back pain. But she also felt empty afterwards, so she asked for small implants to be placed.

Replacement after Removal

This patient had her implants removed after nearly a dozen surgeries because she finally gave up. After a year, she decided to try again. Despite her extremely damaged tissues, she achieved a lovely result.

Desires Larger

Her implants were too narrow for the width of her chest and did not have adequate volume to fill the upper breast. She wanted her breast to just be full with better cleavage, and placing larger, properly sized implants fixed her problem.

Rippling, Strattice

Rippling is always worst when someone bends over. Note from her breastbone how thin she is (rippling is a problem of thinner patients.) Thickening the area with Strattice cured her rippling problem.

Capsular Contracture

She had severe and painful capsular contracture around her ruptured implants from the 1980's (that was a period of very fragile implants.) All the scar tissue was removed, and newer silicone implants were placed behind the muscle.

Capsular Contracture (Left)

She was happy with her right breast, but the left had grown hard, high, and painful. She had a complete capsulectomy on that side and replacement with a new implant.

Medial/Inferior Malposition - Symmastia

Concave breast bone and large implants caused symmastia. Strattice was used to reduce and strengthen new pockets, and smaller implants were placed. The left implant was also too low.

Severe Rippling

This patient had such large implants they thinned her tissue. And her muscle was damaged, so she lost coverage over the implants. Note the implant fold at 7 O'Clock on the right breast. Strattice was used to thicken the tissue and pull the muscle down.

Capsular Contracture, Strattice

Her left breast was always soft and pretty, but the right kept getting hard after multiple surgeries. The scar tissue was removed and Strattice was placed. The breast has remained soft.

Symmastia, Wants Smaller

It is obvious that her implants were simply too wide for her chest. They could not go anywhere but touch in the center. The central pocket was closed, reinforced with Strattice, and smaller implants were placed.

Deflation

Her left saline implant deflated. Both sides were changed to silicone. Note how much more attractive the right breast became. Compared to silicone, saline implants tend to look like an implant with a mild capsular contracture.

Rippling, Drooping

If a loose and thin breast is underfilled, it will ripple. She was changed to silicone, but the real improvement came from doing a lift (scar is just barely visible on the outer breast on the lower right photo.

Removal, Wants Smaller, Droopy

When she first had implants, she liked being large, but with teen daughters she wanted to "just have a little something." At first she wanted smaller implants, but she had enough tissue to have them removed with a lift. Scars still red at 6 mos.

Drooping

This woman always had misshapen breasts, and nothing was done at the first operation to try to fix them. They got worse after nursing. She had repositioning of implants along with a lift that didn't just raise the nipples, but also moved them outward.

Capsular Contracture, Drooping

Capsular contracture can mask the true degree of droopiness. After the scar tissue was removed, the implant filled out the lower breast and it looked more droopy. But the upper bulge went away and the breasts became more attractive.

Symmastia, Wants Smaller

This patient developed symmastia immediately after surgery. Her implant pockets were actually connected. It is clear that her implants were wider than her chest. She was corrected with smaller implants and a neosubpectoral pocket.

Wants Smaller

These very large implants were placed through the nipple and were too large and uncomfortable for her. Note the distracting scar around her areola. While some Americans use this incision for Asian patients, it is rarely used in Asia.

Superior Malposition, Wants Larger

It is hard to know from a picture that this is not capsular contracture. But she was soft; the implants were just too high, and that is why she had the upper bulge. The lower pockets were adjusted and larger implants given as she wished.

Implant Removal, Rippling

Her muscle was damaged at her first operation, so she kept having rippling and distortion after multiple attempts to fix. Strattice could have helped, but she just wanted to stop spending money on her breasts and put it behind her.

Contracture, Rippling, Strattice

Her implants were supposed to be behind the muscle, but the muscle was damaged which caused the upper inner rippling. Strattice reinforced the muscle and created enough coverage to stop the rippling.

Drooping (Bottoming Out), Wants Smaller

This patient has had large implants for years, and already had a lift once. But the heavy implants stretched her again. Now she wants a longer lasting result, so the lift was redone and smaller implants placed.

Wants Smaller

This very athletic woman liked her implants, but they were just a bit big for her given how thin and active she is. Though they do not appear to be a lot smaller in the photograph, they really changed the way she felt about her breasts.

Inferior Malposition

As her implants slid down, the nipple appears to rise up and the distance from the nipple to the bottom lengthened. She was repaired with a "neosubpectoral pocket", a new technique Dr. Teitelbaum has published and lectured about.

Wants Smaller, Removal

She acknowledged that her implanted breasts were pretty. But she started doing triathlons and wanted to just be as thin as possible. Her breasts ended up small but with a very cute shape.

Wants Smaller

Very common story of a woman whose boyfriend paid for and talked her into enormous implants. She developed neck and back pain, and finally wanted implants that were comfortable. Note the loose skin along the inner breast; is from the big implants.

Drooping, Wants Smaller Implants

She "emptied out" after babies and had very large implants placed, which caused her to droop and were always too large. Smaller implants were placed and a lift was done. At 6 months the scars are still very visible, but faded over time.

Medial and Superior Malposition (Right)

She has had multiple surgeries to even out her breasts, but the right remained high and to the center, so that it was touching the left breast. Her tissue is so damaged that the result is not perfect, but at least the implants are at the same height.

Implant Removal

She never liked the upper bulge, and though that could be fixed, she decided she no longer wanted implants. Her breasts are small, but they are absolutely beautiful. Explantations often look better than expected if tissues are good.

Wants Larger

If you look carefully, the upper poles of both breasts are a bit concave, and after surgery they are full. She didn't want a big change, only enough to be full. She also wanted her breasts evened out.

Superior Malposition

Her implants were placed via the armpit incision. Sometimes it is difficult to get the implant in the right position from that incision. Careful release of tissues allowed the implant to settle in a proper position.

Medial/Inferior Malposition - Symmastia and Wants Smaller

Her implants are wide, but they were also placed too close together. Note how that tips her nipples outwards. Strattice was used to reinforce the tissues and keep the implants more outwards, and smaller implants were placed.

Inferior Malposition - "Double Bubble"

Her implants slid downwards, beneath her breasts. The lowest bulge is the implant, and the upper bulge is her breast sitting on the implant. The lower pocket was precisely closed off, pushing the implants back up to the proper position.

Superior Malposition, Medial Malposition

The implants were inaccurately placed from a belly button approach, leaving the left implant too high and too much towards the center. Scar tissue was removed and accurate pockets created.

Wants Larger

Her wish was not more size per se, but to be more full on the top and to be closer together in the center. Obviously, that meant having larger implants, though the look itself just looks prettier more than it looks larger.

Wants Smaller, Capsular Contracture, Drooping, Removal

Her breasts always felt too high and disproportionate. She had several failed attempts at treating capsular contracture. She just wanted to be a perky A or B cup, so the implants were removed and she had a lift. Scars are still red here at 3 months.

Inferior Malposition, Larger implants

Whether due to surgeon error or weak tissues, her implants slid downwards. She also wanted to be larger. The lower pocket was closed off and new implants placed. Note the improved nipple orientation just from the implants being in the right place.

Wants Larger, Drooping

She had high profile implants, which are very round, too narrow for her, and have an abrupt step-off on the top. Larger moderate profile implants fixed those problems. She is droppy but does not want a lift.

Drooping, Wants Smaller Implants

This older but athletic woman wanted smaller and perkier implants. After replacing with smaller implants and doing a lift, she looks much better three months after surgery. Scars will fade and shape will improve with time.

Capsular Contracture

Capsular contracture narrows an implant, but her implants were also too narrow and high projecting to begin with. She had a complete capsulectomy and placement of silicone behind the muscle, and a donut lift. Her new implants are actually larger.

Desires Smaller, Removal

This patient was a D and wanted smaller implants to be a B. But she had enough of her own tissue to be a B with the implants removed.

Contracture, Saline Deflation

Both sides were contracted and hard, and then the right started leaking saline. Note how the nipple incision indented. Scar tissue was removed and larger silicone implants placed. But with the scar tissue removed, she still looked smaller.

Medial/Inferior Malposition - Symmastia and Wants Smaller

Her implants are too wide for her chest, and so they met in the center. The central pockets were closed off and smaller implants were placed.

Drooping, Wants Smaller, Removal

This woman gradually gained weight, mostly in her chest. Her breast were too large and pendulous. She wanted them smaller and perkier. After the weight gain, she had adequate tissue of her own, so implants were removed and she had a lift.

Rippling

Significant upper inner rippling is visible on the right breast along with distortion of it. Her muscle had been damaged from previous surgery. Strattice was used to regain some muscle coverage and thicken her tissues.

Inferior Malposition and Rippling

As her left implant slid down and out, the tissue over it became thinner and the rippling of the saline became more visible. The outer pocket was closed off, moving the implant inwards. Saline was changed for silicone.

Drooping, Wants Smaller, Removal

This woman went through a series of lift and implant changes, but she kept restretching each time. She realized she had adequate volume of her own, so her implants were removed and the lift redone.

Drooping, Lateral Malposition, Wants Larger

Her implants were too narrow, the left was too far to the side, she was droopy, and she wanted more cleavage. Larger implants were moved towards the center and a donut lift was performed.

Implant Removal

She always felt her implants looked and felt unnatural. While switching to a smaller silicone implant could have solved those problems, she was very happy to no longer have to deal with implants. Her tissue quality was good so she had a nice outcome.

Drooping, Wants Smaller Implants

She had gained weight in the 23 years since her implants were placed. She was starting to get into working out and losing weight, and just wanted them out. The implants were removed and an anchor scar lift was done.

Capsular Contracture

Her breasts were very round, hard, far apart, and painful. The scar tissue was removed. Though she looks smaller, the new implants are actually bigger. Note the improvement of cleavage and overall balance of the breasts.